U.S. to Operate 26 State Health Exchanges with Little Local Help

The Obama administration said
on Tuesday that it will operate federal online health insurance
marketplaces in 26 of the 50 U.S. states with little or no input
from local state officials.

WASHINGTON, Feb 19 The Obama administration said
on Tuesday that it will operate federal online health insurance
marketplaces in 26 of the 50 U.S. states with little or no input
from local state officials.

The U.S. Department of Health and Human Services announced
that a total of 24 states, including six with Republican
governors, plus the District of Columbia, are on track to run
their own marketplaces, known as healthcare exchanges, or to do
so in partnership with the federal government.

The new tally, which follows a Feb. 15 deadline for states
to request a federal partnership exchange, underscores the
logistical challenge facing the administration as it moves to
set up federal marketplaces less than eight months before the
Oct. 1 opening of plan enrollment.

"No matter where a qualified consumer lives, he or she will
have access to coverage through a marketplace," Health and Human
Services Secretary Kathleen Sebelius said in a government blog
post.

She also emphasized that states which have not opted for a
state-run or federal partnership exchange will still be able to
apply to run their own in future years.

The exchanges, which are being set up under President Barack
Obama's 2010 healthcare reform law, will offer federally
subsidized private health insurance to working families that
qualify for assistance. An estimated 26 million people, many of
them now uninsured, are expected to obtain coverage through a
healthcare exchange over the next 10 years.

But the exchange plan, like other provisions of the Patient
Protection and Affordable Care Act, has met with resistance from
states, mainly those with Republican leadership.

An administration plan to expand the Medicaid program for
the poor to another 12 million people also faces stiff
Republican opposition among states.

HHS said on Tuesday that it received new applications for
federal partnership exchanges from Iowa, Michigan, New Hampshire
and West Virginia. Three other states - Delaware, Illinois and
Arkansas - already have partnership exchanges in the works.

Sixteen states and the District of Columbia are moving to
operate their own online marketplaces, while Utah is asking the
government to certify its existing exchange for small groups.

Partnership exchanges allow state officials to have a role
in qualifying insurance plans, determining beneficiary
eligibility or both.

In contrast, the 26 states that have opted not to operate
their own exchanges or partner with Washington would have little
to do with the operations, which could come to dominate local
health insurance markets in coming years.

Some of those states, including Ohio, have signaled an
interest in preserving their role in local markets, particularly
in the area of plan management.

Sebelius offered no details, but said: "Several other states
have suggested their own approaches to contributing toward plan
management in their marketplace in 2014."